WP Chung O T in Craniofacial Surgery 9781496348265

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Operative Techniques in Plastic Surgery: Craniofacial

FIG 1  • 3D CT reconstruction of craniosynostosis subtypes. Metopic cranio- synostosis (trigonocephaly) in frontal view ( A ), oblique view ( B ), and top-down view ( C ). Unilateral coronal craniosynostosis (anterior plagiocephaly) in frontal view ( D ), oblique view ( E ), top-down view ( F ). Bilateral coronal craniosynostosis (brachycephaly) in frontal view ( G ), right lateral view ( H ), left lateral view ( I ), and top-down view (J) .

count, preparation for blood replacement, monitoring for air emboli (Doppler, end-tidal CO 2 , mean arterial pressure, CVP), and, in selected cases, coagulation studies to support reduction in blood. ■■ Plan for admission to a postoperative care setting consistent with potential need for urgent care.

■■ Disadvantages: ■■ Bone defects are more difficult to “fill in” nonoperatively. ■■ Bone is more difficult to remodel at approximately 1 year of age. ■■ Potential reduction in brain function related to delay

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Preoperative Planning

Positioning

■■ Generally, once the decision to perform surgery has been made, and with confirmatory clinical and/or CT exam, preparation includes appropriate supports from blood loss to include monitoring, review of current status of blood

■■ Typically, the patient is placed supine for optimal supraor- bital rim advancement regardless of etiology of the nonsyn- dromic craniosynostosis.

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